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General NPI Number Information
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NPI Number | 1386923183
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Entity Type | Individual
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Provider Name | VICKI GRANET SEMEL PSYD
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Gender | Female
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Dates
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Enumeration Date | 08/10/2011
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Last Update Date | 08/10/2011
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Provider Practice Location Address
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Address Line | 301 S. LIVINGSTON AVE 2ND FLOOR
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City | LIVINGSTON
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State | NJ
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Zip | 07039-3932
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Country | US
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Telephone | 973-629-1006
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Fax |
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Provider Business Mailing Address
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Address Line | 301 S. LIVINGSTON AVE 2ND FLOOR
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City | LIVINGSTON
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State | NJ
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Zip | 07039-3932
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Country | US
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Telephone | 973-629-1006
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number | 000372-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 35S100160600
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License Number State | NJ
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